Their $13 million expansion and renovation isn't even finished, but already officials at North Arundel Hospital are talking about the next expansion, which they say will be aimed more at molding services to match patients' and insurers' needs rather than bricks and mortar.
The hospital is considering developing centers for orthopedics, gerontology and psychiatry. The centers would combine surgical services, inpatient care, outpatient therapies and even support groups for the area's aging population, capitalizing on the appeal of one-stop-shopping in a convenient location and an aging North County population.
In addition, the hospital is looking for ways to snare more health care contracts and is exploring the idea of putting doctors and basic medical labs in communities in the northern half of the county to lure patients. Last month, it bought an Odenton office building to renovate as doctors' offices and has its eye on other sites.
The moves come at a time when big businesses and managed health care programs are trying to cut costs and increase efficiency while the industry itself is in turmoil over how to meet the nation's health care needs. "It all relates to money," said hospital spokesman Kevin Murnane.
Last week, the hospital completed the bulk of its internal planning documents, many of which are private because it does not want to tip off other health care providers in the highly competitive market.
Hospital officials wrote of creating "centers of excellence" to provide comprehensive services in orthopedics, gerontology and psychiatry that are under consideration, said James R. Walker, hospital president.
The elderly make up 40 percent of North Arundel's patients, and they need a variety of convenient services, including adult day care.
Because the elderly are more likely to break hips, they require inpatient orthopedic surgery and outpatient physical therapy. The hospital offers both now but could expand and combine those into an orthopedic center, Mr. Walker said.
"We now have 20 orthopedic surgeons. We feel with this natural strength the hospital ought to be able to develop into an orthopedic center of excellence," he said.
Last year, nearly 2,000 of the hospital's 15,000 inpatients were treated for orthopedic problems.
In addition, arthritis and similar chronic ailments often require a mix of medication, physical therapy and exercise. It could be attractive to run all the programs out of one place, Mr. Walker said.
This summer, the hospital started including several Arthritis Foundation programs -- exercise and support groups -- to attract sufferers.
The hospital also began moving into psychiatric care last spring by adding a full-time staff physician as chief of the 19-bed psychiatric unit and by participating in dosing studies of drugs used for depression and psychoses.
The treatments are approved by the Food and Drug Administration, and the studies are financed by drug-manufacturers.
And, to help with planning, the hospital has hired the Gallup polling organization, at a cost of $30,000, to find out what North County residents think of North Arundel's services.